EFFECTIVENESS
OF
DISEASE MODIFIED THERAPY

Name;Medication;Indication;Clinical Effect

<b>Avenox</b>;INFβ-1a<br>Biogen 1996<br>30mcg IM, QW;Relapsing forms of MS to slow accumulation of physical disability and decrease frequency of clinical exacerbations, CIS with MRI features consistent with MS;ARR reduction: 18%<br>0.56 relative rate of developing secondary relapse from placebo.<br>Disability progression: 37% relative risk reduction in 24-week CDP <b>Plegridy</b>;INFβ-1a<br>Biogen 2014<br>125mcg SC QOW;Relapsing forms of MS;ARR reduction: 36% at 1 year<br>Disability progression: 39% relative risk reduction in 24-week CDP at 1 year <b>Betaseron</b>;INFβ-1b<br>Bayer 1993<br>(0,25mg SC QOD);Relapsing forms of MS to reduce frequency of clinical exacerbations, CIS with MRI features consistent with MS;ARR reduction: 31%<br>Disability progression: No effect <b>Rebif</b>;INFβ-1a<br>Serono 1996<br>(22mcg & 44mcg SC TIW);Relapsing forms of MS to decrease frequency of clinical exacerbations and delay the accumulation of physical disability;ARR reduction 29% (22 µg) 32% (44 µg)<br>Disability progression: 22% (22 µg), 31% (44 µg) reduction of CDP <b>Copaxone</b>;Glatiramer acetate<br>ТЕVA 1996<br>(20mg SC QD 40mg SC TIW);RRMS for reduction of the frequency of relapses, CIS with MRI features consistent with MS;ARR reduction: 29% (QD)<br>Disability progression: No effect <b>Tecfidera</b>;Dimethyl fumarate<br>Biogen 2013<br>(240mg PO BID);Relapsing forms of MS;ARR relative reduction: 44% and 53%<br>Disability progression: 21% and 38% relative risk reduction in 24-week CDP <b>Aubagio</b>;Teriflunomide<br>Genzyme/Sanofi 2012<br>(7mg & 14mg PO QD);RRMS;ARR relative reduction 31% (7mg and 14mg)<br>Disability progression: 30-32% relative risk reduction in 12-week CDP <b>Gilenya</b>;Fingolimod<br>Novartis 2010<br>(0.5mg PO QD);Relapsing forms of MS to include CIS, RRMS and active SPMS, in patient 10years of age and older;ARR reduction: 55% vs.placebo, 51% vs.IFNβ-1a QW<br>Disability progression: No effect <b>Mayzent</b>;Siponimod<br>Novartis 2019<br>(2mg PO QD);Relapsing forms of MS to include CIS, RRMS, and active SPMS, in adults;ARR relative reduction: 55%<br>Disability progression: 21% relative risk reduction <b>Mavenclad</b>;Cladribine<br>Serono 1993<br>(Cumulative dose of 3.5mg/kg PO in 2cycles);Relapsing forms of MS to include CIS, RRMS, and aSPMS in adults. Because of its safety profile, its use is generally recommended for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug for the treatment of MS;ARR relative reduction: 58%<br>Disability progression: Time to 3 months disability progression 0.67 hazard ration <b>Tysabri</b>;Natalizumab<br>Biogen 2004<br>(300mg IVx1 Q 28days);Relapsing forms of MS to include CIS, RRMS, and aSPMS in adults;ARR reduction: 67%<br>Disability progression: 42% risk reduction in 12week & 54% risk reduction in 24week CDP <b>Ocrevus</b>;Ocrelizumab<br>Genentech 2017<br>(600mg IVx1 every 6months);Relapsing or primary progressive forms of MS;ARR relative reduction: 46 & 47% vs.IFNβ-1a TIW<br>Disability progression: 40% risk reduction 24week CPD vs.IFNβ-1a TIW (pooled data)<br>21% risk reduction of 12-week CDP in PPMS <b>Lemtrada</b>;Alemtuzumab<br>Genzyme/Sanofi 2001<br>12mg IV QD in 2cycles x5days & x3days;Relapsing forms of MS. Its use should be reserved for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug for the treatment of MS;ARR relative reduction: 49% & 55% vs.INFβ-1a TIW<br>Disability progression: 0 & 42% risk reduction in 6months vs.INFβ-1a TIW <b>Novantrone</b>;Mitoxantrone<br>Immunex 2000<br>12mg² IV every 3months over 2years;RRMS, RPMS, SPMS to reduce neurological disability and frequency of relapses;ARR reduction: 66% vs.placebo, 76% on Novantrone plus MP vs.MP<br>Disability progression: EDSS change from baseline -1.3 vs.+2.3 on placebo, EDSS change from baseline -1.1, Novantrone plus MP vs.0.1 on MP alone.